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Screening for prostate cancer means that laboratory tests are done to detect a disease before the symptoms appear.
Thus, prostate cancer screening aims to detect the disease in its early stages, when treatment can be most effective. It is remarkable that one in seven men will be diagnosed with prostate cancer during their lifetime, a frequency that exceeds that of lung and colon cancer
Screening is necessary after the age of 50, but in people with a family medical history, the first prostate screening should be done at the age of 40-45. When the tumor is detected in the early stages, it is easier and more effective to treat.
Screening can be done with two tests, which will be determined by the urologist. If the results have abnormal findings, the doctor will indicate the necessary further laboratory testing, in order to determine whether the examinee is suffering from prostate cancer or not.
The first is a blood test to investigate prostate-specific antigen (ProstateSpecificAntigen – PSA), which is released into the blood in small amounts. The measurement of high PSA rates, or continuously significantly increasing, raises the suspicion of prostate cancer.
The second is the digital rectal examination, which allows the evaluation of certain disturbances in the shape, texture, or size of the prostate, which may indicate the presence of a tumor.
If prostate cancer is suspected, an ultrasound-guided biopsy is performed, with which tissue pieces are taken from the prostate through the rectum, which is sent for histological (microscopic) observation. The histological examination will determine the presence or not of cancerous cells and the degree of malignancy of cancer.
Only the 20% of men who undergo a prostate biopsy and have a PSA between 3-10 are diagnosed with cancer. This percentage increases with increasing PSA. In fact, the higher the PSA and the lower the ratio of free to total PSA, the higher the probability of prostate cancer.
A negative prostate biopsy does not always rule out cancer. Additional biopsies may be needed if the PSA remains elevated, or increases over time. If prostate cancer is diagnosed, careful evaluation by the urologist will determine whether the cancer is significant and requires treatment or non-significant/inactive and requires only observation.
Information selected - indicative with sources: Interpretation of Diagnostic Tests - J.Wallach and https://labtestsonline.org
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Edited by : Ioannis Grattisia Head of Laboratory / MSc Clinical Biochemistry - Molecular Biology
April 2019
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